Whitepaper Optimizing Quality Management with Your EHR: Getting

Transcription

Whitepaper
Optimizing Quality Management
with Your EHR: Getting Paid
More for What You Do Best
athenahealth, Inc.
Published: December 2010
Optimizing Quality Management with Your EHR: Getting Paid More for What You Do Best
Executive Summary
Physicians have always been dedicated to finding the best methods of patient care, implementing them,
and sharing them with other physicians. In recent years, insurers, private quality organizations, and the
government have standardized some of these methods and developed programs that reward physicians for
implementing them. These programs are also aimed at cutting health care costs. At a time when practices
are facing declining income, the rewards for participation can contribute significantly to your bottom line. But
the rewards are only worth seeking if the cost—in time and money—of collecting data for, and reporting it to,
quality programs doesn’t outrun the potential gain, as many physicians fear it will. This is where your EHR and
the services provided by your EHR vendor can make a significant difference. EHR capabilities and EHR vendor
services should include:
1. Notice of, and enrollment in, quality programs appropriate to your practice, as well as continuous
tracking, monitoring, and incorporation of new programs and opportunities;
2. Tools that make it easier to deliver and monitor quality care as prescribed by those programs;
3. Population management tools that make it easy to close the care gap for patient populations targeted by
quality programs; and,
4. Electronic capabilities and support that remove the administrative burden of collecting and submitting
quality data to the programs.
With these four capabilities in place, your practice can not only maintain or improve the quality of patient care,
but also reap the financial benefits of delivering high quality care. And you’ll be well-positioned as health care
reform moves the industry toward quality-based reimbursement.
www.athenahealth.com
2
No physician needs to be told that quality care produces better outcomes. Nor do you need to be told that
sharing best practices for treatment across the health care system is important. Physicians have been doing
this since the inception of modern medicine. What is new is the increasing number of quality programs
seeking to improve outcomes and lower costs by financially rewarding physicians for applying evidence-based
medicine to health care delivery. These programs—sponsored by insurance companies, quality organizations,
and state and federal governments—provide a significant opportunity for practices to reap rewards for doing
what they do best: providing quality care.
But there is a fly in the ointment. Many practices, small and large, have found—and studies support—that the
time and money they invest in finding and enrolling in appropriate quality programs, changing their workflow
to follow program procedures, monitoring compliance with quality measures, and reporting data to the
programs can outweigh the financial and outcome benefits of participation.
This whitepaper examines the opportunity provided by quality programs, the challenges inherent in finding
appropriate programs and participating in them, and the solution for overcoming these challenges and
profiting from participation.
An EHR Partner Makes Quality Management Practical
Deerpath Primary Care in Libertyville, Illinois, a
growing practice with three physicians and four
other providers, was aware of opportunities to
improve care through participation in quality
programs such as The Physician Quality Reporting
Initiative (PQRI), Bridges to Excellence,
ePrescribing, and Patient Centered Medical Home.
However, the prospect of finding the right programs
and enrolling in them, integrating program
guidelines into the practice workflow, monitoring
adherence, managing patient populations, and
reporting was daunting.
“It would have taken two staff members just
to manage the patient populations for these
programs,” says Lisa Dandrea, MPAS, PA-C, director of operations for the practice. “Even enrollment was
time-consuming.”
athenahealth’s Quality Management Initiative and the athenaClinicals EHR service provided a better way.
athenahealth found the right programs for Deerpath (and continuously monitors new ones), handled
enrollment in some programs, integrated program guidelines into the practice’s workflow via the EHR,
enabled population management, generated reports, and automatically submitted data electronically to
programs that accept it.
“It would be difficult to find the staff time to participate in these programs without athenahealth,”
Dandrea adds. “They make it possible for the average-size practice to deliver better patient care, and
potentially increase revenue, without the adding more employees.”
3
The Opportunity: Better Outcomes and Reporting Can Boost
Revenue
For starters, what is actually meant by “quality management”? In the health care industry, quality management
is simply the process of measuring quality performance to identify gaps in care and areas for improvement.
This information is used to develop processes to enhance patient care and improve the efficiency of health care
delivery. There are multiple steps and organizations involved in the formal creation of a quality program:
1. A clinical guideline is developed by a physician or disease organization such as the American Academy of
Family Physicians (AAFP), American Diabetes Association (ADA), or American Academy of Neurology (AAN)
(e.g., studies have shown that diabetics should receive at least two A1C tests per year).
2. Clinical quality organizations such as the Agency for Healthcare Research and Quality (AHRQ), National
Quality Forum (NQF), and National Committee for Quality Assurance (NCQA) work with physician
organizations to develop measures based on guidelines (e.g., the rate of patients between 18 and 75 with
diabetes that had A1C tests twice during the year).
3. Program sponsors (such as insurers, quality organizations, and government agencies) adopt measures (e.g.,
the percentage of patients between 18 and 75 with diabetes who received an A1C test once per year) and
create programs that financially reward physicians for following the guidelines.
The benefit of following well-established clinical guidelines is obvious: better outcomes. Patients who get
regular, well-vetted treatments are more likely to remain healthy, which benefits the organization sponsoring the
program as well as the patient.
In these times of declining physician reimbursement, when many physicians are struggling with more
mandates and less income, the financial rewards for following clinical guidelines and participating in ACOs
could be significant. For example, Pay-for-Performance (P4P) programs are becoming an important part of
the reimbursement environment. (There is also evidence that P4P programs can improve the performance
of the lowest-performing providers in a practice.1) Payments from P4P programs average 7% of physician
compensation, though they can be as high as 30%.2 Figure 1 shows the variety of P4P programs available.
Figure 1. Growth of P4P Programs
P4P Sponsors by Type
Pay-for-Performance Programs
139
120
148
107
State Government Medicaid
25
Federal Government - CMS
7
84
80
40
Payer Programs
92
Project Deployment
9
Coalition Employer
15
39
P4P Programs by Type
2003
2004
2005
2006
2007 Total Enrollment: 57.4M*
2007
Number of
Programs
Number of Programs
160
160
120
80
40
0
130
72
PCP
Specialist
56
Hospital
* Does not include Centers for Medicare and Medicaid Services. PCP is a primary care physician.
Source: 2007 Med-Vantage, Inc., IHA and the Leapfrog Group. 2007 National P4P Study. All rights reserved.
4
The quality program that many practices will have to attend to first, if they’re not already doing so, is the
CMS EHR Incentive Program created as part of the HITECH Act. This Act provides federal stimulus money to
physicians who implement and demonstrate “Meaningful Use” of a certified EHR as defined by CMS in July
2010. (For more information, see “What is the HITECH Act?” at http://www.athenahealth.com/hitech.php.)
Figure 2. HITECH Act – Medicare Physician Incentive Payments*
HITECH Act – Medicare Physician Incentive Payments*
Adopted EHR
in 2011
Adopted EHR
in 2012
Adopted EHR
in 2013
Adopted EHR
in 2014
Adopted EHR
in 2015
2011
$18,000
$0
$0
$0
$0
2012
$12,000
$18,000
$8,000
$0
$0
2013
$8,000
$12,000
$4,000
$0
$0
2014
$4,000
$8,000
$2,000
$15,000
$0
2015
$2,000
$4,000
$8,000
$12,000
$0
2016
$0
$2,000
$4,000
$8,000
$0
Total
$44,000
$44,000
$39,000
$35,000
$0
10% additional
payment For Health
Professional
Shortage Areas
$4,400
$4,400
$3,900
$3,500
Total
$48,400
$48,400
$42,900
$38,500
Year
$0
* Chart provided by Chilmark research
* Numbers interpreted from the American Recovery and Reinvestment Act of 2009
* No incentive payments will be made after the year 2016.
To give another example, the Physician Quality Reporting Initiative (PQRI) program’s rewards will be in effect
through 2014.3 However, the Patient Protection and Affordable Care Act set penalties for nonparticipation in
PQRI programs. 4 In 2015, nonparticipating practices will see their Medicare and Medicaid payments reduced
by 1.5% and in 2016 and beyond the reduction will be 2%.5
In order to benefit financially from quality program participation—and avoid future penalties—practices must
find appropriate programs, enroll in them, and then figure out how to provide all the data required to trigger
financial rewards without incurring additional costs.
5
The Challenge: Participating in
Quality Programs Costs Money &
Time
It is important that a practice have a quality strategy
that involves collecting quality information, doing
internal reporting on that data for quality improvement
purposes, and being able to submit that data to outside
organizations for P4P incentives or preferential contracts.
An important part of this quality strategy should be taking
an assessment of the P4P opportunities that are available
and making sure to take part in the programs that are
applicable to the practice. In fact, there are more than 150
P4P programs in the U.S., and that number is increasing.7
Only a program that rewards the procedures your practice
performs regularly will be worth participating in, so you
may need expert guidance in order to choose wisely from
among the programs available.
Once your practice has enrolled in one or more quality
programs, the work really begins in earnest. Practices
may need to track anywhere from 50-100 quality measures
across multiple programs—measures that must be
followed, monitored, and reported on in order to receive
incentives. And, although there may be similarities in
measures, each program has unique quality measure
specifications, data collection methods, data submission
timeframes, and methods.
A recent study from the University of North Carolina,
published in Annals of Family Medicine in late 2009, makes
it clear that the cost in time and money for participation in
quality programs is real.8 The study, which looked at the
quality participation activities of eight diverse practices,
notes that, “across these practices and programs, the
major expenses included planning, training, registry
maintenance, visit coding, data gathering and entry, and
modification of electronic systems. Considerable variability
across practices was noted, underscoring the notable
challenges to performing quality improvement work…”9
Figure 3, reprinted with permission from that study,
defines the specific areas where costs were incurred by the
practices studied as a result of their participation in the
following four quality programs: PQRI, Community Care
of North Carolina (CCNC), Bridges to Excellence (BTE), and
Improving Performance in Practice (IPIP).
Patient-Centered
Medical Home
A quality program often regarded as
one that points to the future of medical
care coordination is the PatientCentered Medical Home (PCMH) quality
program sponsored by the National
Committee for Quality Assurance
(NCQA). NCQA defines PCMH as “a
health care setting that facilitates
partnerships between individual
patients and their personal physicians,
and when appropriate, the patient’s
family.
Care is facilitated by registries,
information technology, health
information exchange, and other
means to assure that patients get the
indicated care when and where they
need and want it in a culturally and
linguistically appropriate manner.
There are nine PPC® standards,
including 10 must-pass elements,
which can result in one of three
levels of recognition. Practices
seeking PPC®-PCMH™ use a webbased data collection tool and
provide documentation that validates
responses.”6
This is a demanding program with
guidelines covering everything from
care management to electronic
prescribing to patient access and
communications. Gathering and
reporting the data required by PCMH
without overtaxing a practice’s
administrative staff and systems
is difficult without the aid of a
sophisticated EHR system and an EHR
vendor that provides services to take
on much of the administrative burden.
6
Figure 3. Types of Costs Incurred for Quality Program Participation10
Categories of Costs Identified and Estimates for Each Program and Practice
Direct Cost of Personnel Time
Category
Definition
Types of costs
identified and
estimated
Quality Data Capturea
Data Collecting and
Reporting a
Cost of hardware, software,
program materials, or
participation feesb
Patient care or administrative
process alterations caused by
program participation
Time expended specifically on
data collecting and reporting
for the program
 A
pplication fees
 Personnel time to decide
whether to participate in
the program
 On-site staff time provided
and paid for by the
program and devoted to
extracting data elements
Non-personnel Costs
 C
ost of written program
materials
 S
oftware or software
upgrades
 H
ardware
 D
ata backup (electronic or
paper), data security
 L egal consultations for
agreements
 E
xcess clinical supplies
needed to participate
 Personnel time to decide
on measures to work on
within the program
 Meeting times (formal
and informal) to
inform practice staff of
program expectations,
requirements, changes in
staff roles and duties
 Regional meetings
with other practices or
administrators of the
program(s)
 Report generation time,
and/or report review time
 Data entry and upload
 Developing and
maintaining a list of active
patients for whom a
measure applies; work to
contact patients who are
potentially inactive
 Chart audit/data
abstraction
 Staff time devoted to
improving information
interoperability necessary
for data capture,
submission, and crosscommunication with
different electronic
systems
 On-site staff time provided
and paid for by the
program and devoted to
educating and/or assisting
the practice
Note: Staff/personnel time costs are calculated as follows: cost = (hours devoted to task) (hourly salary + 22% [for benefits]). Source for
benefit rate: http://www.pohly.com/books/mgmacost-multispecialties.html.
a
Staff includes any employee, clinician, or administrator associated with the practice or program.
b
Includes only the proportion of costs devoted to collecting and reporting data specifically for the reporting program.
Adapted with permission from “Cost to Primary Care Practices of Responding to Payer Requests for Quality and Performance Data.” Annals of
Family Medicine, Vol. 7, No. 6, November/December 2009. Copyright 2006 American Academy of Family Physicians. All Rights Reserved.
The North Carolina study also quantified the average costs incurred by the practices for participating in these
four quality programs. Those costs are delineated in Figure 4 from the same study.
7
Figure 4. Actual Costs Incurred for Quality Program Participation11
Estimated Implementation and Maintenance Costs of Performance Data Reporting in 8 Primary Care Practices, By
Program and Practice
Implementation Costs, $
Program
and
Practice
Total
Per
Clinician
FTE
Incurred
by
Programa
Maintenance (Annualized) Costs, $
Total
Per
Clinician
FTE
Incurred
by
Programa
Major Cost Sources, $
Physician Quality Reporting Initiative (PQRI)
A
5,949
425
0
12,200
871
0
B
920
368
0
207
83
0
D
22,200
11,100
0
8,657
4,329
0
H
5,894
475
0
7,200
581
0
S/AM: Data entry by clinicians and billing staff
None
S: Personnel time to collaborate with others
(laboratory, Medicare, a patient revenue
management company); internal meetings to plan
and comply with the program
S/AM: Technical support with server, and server
upgrades
S: Data entry time; leadership meetings
AM: Data entry by clinicians and IT personnel costs
for program monitoring
Improving Performance in Practice (IPIP)
B
3,571
1,428
2,545
5,044
2,018
141
C
2,689
2,689
1,000
4,229
4,229
820
F
18,210
3,035
1,673
11,563
1,927
1,673
S/AM: Maintaining the active list of patients; data
entry
S/AM: Data abstraction by clinician
S/AM: Meetings; staff time to develop workaround for laboratory values (because of lack of
information interoperability)
Bridges to Exellence: Diabetes (DPRP)
A
8,658
618
0
2,940
205
0
G
4,270
488
45
N/A b
N/A b
N/A b
S: Internal audit to verify data accuracy (not
required for QI organization).
S/AS: Adminitrative meetings
S: Planning and decision making
S: Data entry and backup work
Bridges to Excellece: Physician Practice Connections (PPC)
A
11,294
807
0
N/A b
N/A b
0
S: Meetings of decision makers and/or
stakeholders
Community Care of North Carolina (CCNC)
A
1,865
133
1,266
2,954
211
1,147
B
709
284
268
146
58
197
C
563
563
261
N/A b
N/A b
N/A b
D
N/Ac
N/Ac
N/Ac
719
360
1,628
E
N/Ac
N/Ac
N/Ac
761
146
1,022
G
N/A
N/A
N/A
c
c
c
2,788
319
5,477
S/AM: Regional meeting attendance
S: Initiation of new processes for some measures;
meetings and work to credential clinicians
AS: Report review
S/AS: Regional meeting attendance; chart audits
required staff participation due to EHR
S/AS: Internal meetings; audit preparation; audits
required office staff participation because of EHR
AM: Network meetings, some report review by CEO
S/AM: High Medicaid volume resulted in case
manager on site, who provided direct teaching
of personnel; audits required office staff
participation because of EHR
AM = annualized maintenance cost; CEO = chief executive officer; EHR = electronic health record; IT = information technology; N/A = not
available; QI = quality improvement; S = start-up cost.
I ncludes only the estimated cost of program services delivered on-site in the primary care practice.
No maintenance participation costs available either because of nature of program (no maintenance phase of reporting) or insufficient time in
program.
c
CCNC started in 1998; several practices did not have access to costs data from implementation.
Adapted with permission from “Cost to Primary Care Practices of Responding to Payer Requests for Quality and Performance Data.” Annals of Family
Medicine, Vol. 7, No. 6, November/December 2009. Copyright 2006 American Academy of Family Physicians. All Rights Reserved.
a
b
8
Bridges to Excellence
Quality Program
Bridges to Excellence (BTE) is a
private non-profit organization that
works with outside organizations,
including insurance companies,
EHR vendors, and clinical data
repositories, to facilitate quality
improvement and incentives
through pay-for-performance
programs.
To be eligible for recognition
through BTE, a physician must
achieve minimum thresholds for
quality care assessed through both
process and outcome measures.
The organization has relationships
with some payers who provide
incentives for BTE-Recognized
Physicians treating their patients.
BTE-Recognized Physicians have
opportunities to demonstrate to
the public and to professional
peers that the standards of care
assessed by the program have
been met, such as issuing a press
release and having achievements
posted on BTE’s consumer portal,
HealthGrades
(www.healthgrades.com).
Where applicable, clinicians can
establish eligibility for pay-forperformance bonuses, differential
reimbursement, or other incentives
from payers and health plans.
For more information on BTE, go to
http://www.bridgestoexcellence.
org/Content/ContentDisplay.
aspx?ContentID=18c or write to
[email protected].
The University of North Carolina study concludes that, “Despite
the enthusiasm for quality improvement, reporting activities
have occurred with relatively little regard to the challenges…
practices face in collecting and reporting requested data. These
challenges include inadequate data collection and reporting
systems, multiplicity and inconsistency of measures required
by different quality improvement organizations, the need to
converge or reorganize multiple paper and electronic data
sources, and insufficient financial resources to maintain office
systems and educate office personnel.”12,13
It’s no wonder that practices are skeptical about the value of
participating in these programs. Even after all this clinical and
administrative work is done, practices still might not succeed
in satisfying quality program requirements. In 2008, for
example, PQRI only had a 55% success rate among participating
providers.14
However, practices that capitalize sooner on quality programs,
adjusting their workflows to take advantage of them, will be wellpositioned once quality-based models become the norm—and
before penalties go into effect for not adhering to those models.
Practices should begin to participate in P4P programs at their
earliest opportunity. As providers master optimal EHR workflows
to capture QM data and meet patients’ care needs, they not only
close gaps in care but also make their participation in more P4P
programs easier. This, in turn, makes it easier to achieve quality
recognition and incentive dollars. Providers that get ahead of the
quality management curve early will see a return on their EHR
investment sooner and are more likely to increase ROI over time.
The Solution: An EHR Service that
Enables Profitable Participation in
Quality Programs
It’s a complex process to participate in quality programs. Your
practice will need to find and enroll in the right programs.
Then you’ll need to access quality guidelines and monitor your
practice’s adherence to them. Finally, you’ll have to gather
and submit data to verify that the practice has met program
measures. It’s difficult for a practice, large or small, to go it alone
without all of this becoming a burden. A full-service EHR solution
delivered by a vendor that provides quality reporting services
can make the difference between quality programs being a
burden and their contributing to the practice’s clinical success
and financial bottom line.
9
EHR capabilities and vendor services should include:
1. Notice of, and enrollment in, quality programs appropriate to your practice, as well as continuous
tracking, monitoring, and incorporation of new programs and opportunities;
2. Tools that make it easier to deliver and monitor quality care as prescribed by those programs;
3. Population management tools that make it easy to close the care gap for patient populations targeted by
quality programs; and
4. Electronic capabilities and support that remove the administrative burden of collecting and submitting
quality data to the programs.
With these four capabilities in place, your practice can not only improve the quality of patient care, but also
reap the financial benefits of delivering that high quality care. Let’s look at what each of these capabilities
entails.
1. Notice of, and enrollment in, quality programs
As noted above, quality programs originate from many places and have many purposes, and new programs
are being developed continuously. What practice has the time and staff to keep abreast of new programs as
they arise, investigate their suitability, enroll in them, and incorporate their guidelines and measures into the
workflow? This is where your EHR vendor should come in.
Your vendor shouldn’t just sell you software and disappear; it should be an organization that has its finger
on the pulse of the health care industry and of your practice. Your EHR workflow should always reflect the
latest clinical best practices. In addition, your vendor should be knowledgeable about existing and developing
quality programs and incentives of all kinds that can benefit your practice.
In fact, your vendor should know your practice well enough that it notifies you of any new programs/incentives
that would be financially beneficial for your practice, and then make it as easy as possible for you to enroll—in
some cases even handling enrollment for you.
2. Tools that make it easier to deliver and monitor quality care
Physicians might ask themselves: What good is an EHR if it doesn’t make it easier to both consistently deliver
the highest quality care and reap any financial rewards available for delivering that care—without increasing
the administrative burden? This is the kind of promise that led to the development of electronic medical
records in the first place. Your EHR vendor should be able to deliver on that promise.
In practical terms, this means that quality guidelines should be integrated into your EHR workflow, enabling
physicians to see and act upon them at the point of care. Neither the physician nor practice staff should bear
the burden of making those guidelines available as they are developed and as the practice enrolls in new
programs. Your EHR system should take on the burden of this work for you. Each day, when you go online, the
latest appropriate rules and procedures should be available on each patient’s record. Figure 5 shows a system
where quality guidelines appear directly on the patient record.
10
Figure 5. Quality Guidelines in the Patient Record – at the Point of Care
Using the quality guideline example mentioned earlier, if a physician is treating a diabetic, the patient’s record
should show the guideline about diabetics receiving at least two A1C tests per year. The record should, of
course, make it possible for the physician to order the A1C test electronically, but it should also record the test
being ordered for quality-tracking purposes.
Humana-athenahealth Medical Home Rewards Program
Some payers are innovating with their own programs to financially reward physicians for improving
the quality, efficiency, and coordination of care. In 2010, Humana and athenahealth launched the
Medical Home Rewards Program. Humana will subsidize the implementation cost of athenahealth’s
EHR service for physicians who are eligible for participation. In addition, Humana is so confident
that athenahealth’s clinical platform will deliver quality results that it is waiving the extensive NCQA
Medical Home Recognition requirements for eligible users—while enabling them to earn up to 20%
above their current fee-for-schedule collections paid by Humana.
Through this first-ever (outside of integrated delivery systems) clinical integration of a health
plan, its physician network, and a PMIS/EHR, athenahealth will ultimately integrate payer-derived
clinical data into its network to drive care gap closure and other payer and physician goals. Since
Medicare will eventually require that PCPs meet Healthcare Effectiveness Data and Information Set
(HEDIS) quality measures, practices can get a head start toward meeting these measures and win
incentives for doing so.
Physicians or practices interested in participating in this program can e-mail
[email protected].
11
An EHR vendor that understands how quality program compliance is being achieved by practices nationwide
can make it easier for your practice to achieve compliance. Beyond integrating quality guidelines into the
workflow, your vendor should also be able to help you analyze your workflow and week-to-week performance
for missing procedures or gaps in care.
3. Population management tools that make it easy to close the care gap for
patient populations targeted by quality programs
Patient outreach, also known as population management, is essential for successful participation in quality
programs. Practices must reach out to their patients in order to get them to schedule the checkups, tests,
and procedures required for meeting quality measures. Your EHR system should be capable of zeroing in on
a specific patient population and rolling up population data for convenient reporting. It should be capable
of uncovering a new targeted population within your patient database and enabling you to manage that
population efficiently and effectively.
Your EHR should also allow you to easily and continually communicate with any patient population through
targeted e-mails and voice-mails. It should enable you to build a practice website where patients can get
information and schedule their own appointments, once notified of the need for a checkup, test, or procedure.
Figure 6 provides an example of an EHR system that enables practices to track communications with specific
patient populations.
Figure 6. Patient Outreach/Population Management Screen in an EHR System
12
4. Electronic capabilities and support that remove the administrative
burden
Your EHR system should be capable of automatically capturing the administration of checkups, tests, and
procedures that fulfill quality measures for specific quality programs. The captured data should then be
available when the practice does program reporting—for example, rolling up the data on all diabetics who
received A1C test during the prescribed reporting period. Producing such reports manually is a grueling, timeconsuming process—one of those processes that discourage practices from participating in quality programs.
But with the right EHR system and vendor, the process can be relatively painless and inexpensive. Figure 7
provides an example of quality management reports available through an EHR system.
Figure 7. Quality Management Reports Available in an EHR System
Once the data has been accumulated, practices must submit the data they collect. Methods for submitting
data vary from program to program. Some accept electronic data, others require submission of an Excel
spreadsheet, and still others require inputting the data on a website. Again, this can be a frustrating and
time-consuming process. Your EHR system should be able to automatically submit electronic data to any
program that accepts it. It should also produce reports in the form of Excel spreadsheets, which can either be
submitted to programs that accept spreadsheets or used to speed the input of data on a program website.
There is a Better Way
Participating in quality programs can be good for a practice, clinically and financially, but it can also create an
administrative and financial burden that significantly diminishes, or even cancels out, the financial value of
such programs. With the right EHR system and vendor assisting you, however, the financial rewards for doing
what you do best every day—providing quality care for your patients—can help boost your income and prepare
you for additional changes to health care reimbursement in the future.
13
athenahealth: More money and more control over quality care
athenaClinicals® is a low-investment, high-return, cloud-based EHR designed to address the limitations of
traditional EHRs and make participation in quality programs as easy and rewarding as possible.
athenaClinicals enables you to:
 Stay on top of and enrolled in HITECH Act, P4P, and other incentive programs by continuously tracking,
monitoring, and incorporating new programs and opportunities for your practice behind the scenes;
 Achieve compliance with “Meaningful Use” requirements and get Federal HITECH Act incentives because
compliance is built into the software and continuously updated to keep up with new requirements;
 Use built-in software tools to deliver and monitor quality care as required by quality programs;
 Use built-in population management tools to easily close the care gap for targeted patient populations;
 Offload paperwork, improve care, and meet quality requirements through closed-loop order management;
and
 Achieve all this and much more without the cost and hassle of buying servers, paying up-front licensing
fees, and installing expensive and disruptive software upgrades.
At no additional charge, athenahealth’s back-office services electronically sort and route to charts all faxed
and electronic clinical information—we even build and maintain electronic connections with labs, pharmacies,
hospitals, and HIEs.
lTo learn more about how athenaClinicals can help your practice, visit
www.athenahealth.com or call 800.981.5084.
14
Citations
1.
Journal for Healthcare Quality, Vol. 32, No. 1, pp. 13–22 & 2010 National Association for Healthcare
Quality.
2. Med-Vantage/Leapfrog press release, “Med-Vantage and Leapfrog Present Early Results From 4th
National P4P Survey,” March 9, 2009.
3. H.R. 3590, Patient Protection and Affordable Care Act of 2009 - Summary of Major Provisions, http://www.
aad.org/gov/documents/HSR_overview_final%20bill.pdf, pg. 1.
4. H.R. 3590, Patient Protection and Affordable Care Act of 2009 - Summary of Major Provisions, http://www.
aad.org/gov/documents/HSR_overview_final%20bill.pdf, pg. 2.
5. Ibid.
6. Physician Practice Connections® - Patient-Centered Medical HomeTM, http://www.ncqa.org/tabid/631/
default.aspx.
7. Pay-for-Performance in Safety Net Settings: Issues, Opportunities, and Challenges for the Future/
PRACTITIONER APPLICATION, Young, et al, Journal of Healthcare Management, March 1 2010.
8. Jacqueline R. Halladay, MD, MPH, et al, “Cost to Primary Care Practices of Responding to Payer Requests
for Quality and Performance Data.” Annals of Family Medicine, Vol. 7, No. 6, November/December 2009.
9. Ibid, pg. 495.
10. Ibid, pg. 499.
11. Ibid, pg. 500.
12. Eddy D. Performance measurement: problems and solutions. Health Aff (Millwood). 1998;17(4):7-25.
13. AHRQ Conference on Health Care Data Collection and Reporting: Collecting and Reporting Data for
Performance Measurement. Bethesda, MD: US Agency for Healthcare Research and Quality, 2007.
http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_1248_227079_0_0_18/AHRQ_DataReport_
final.pdf. Accessed Dec 21, 2008.
14. “PQRI Frustration,” Nephrology Times: August 2009 - Volume 2 - Issue 8 - pp 10-11.
15
© 2010 athenahealth, Inc. All rights reserved.
About athenahealth
athenahealth, Inc.
311 Arsenal Street
Watertown, MA 02472
866.817.5738
At athenahealth we offer the leading cloud-based practice
management, EHR, and patient communication services that help
medical groups get more money and more control of patient care.
To learn how our services can help your organization, contact us at
866.817.5738 or www.athenahealth.com.

Whitepaper Optimizing Quality Management with Your EHR: Getting

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